Catholic Hospitals vs. Catholic Bishops?

As tense, last-minute negotiations over details of the Senate's health care bill progressed just before Christmas, one of the most fluid and contentious issues was over abortion coverage -- as it has been since the beginning. In our Dec. 18 story about Sen. Bob Casey's abortion funding amendment -- which became the basis of the compromise that Sen. Ben Nelson supported to get to 60 votes -- we noted the apparently divergent reactions to the process from Catholic groups and wondered if they "could signal an emerging division within the Catholic forces lobbying on health care."

A week later, The New York Times took that a step further and ran a Dec. 26 story by David Kirkpatrick that pronounced an "apparent split" over the health care bill between the U.S. Catholic bishops and the Catholic Health Association, which represents more than 600 Catholic hospitals nationwide, making it a powerful player in the debate.

The Times story noted the statement by Sr. Carol Keehan, president and CEO of the CHA, giving provisional support to Casey's amendment:

"As we understand it, the Senate intends to keep the President's commitment that no federal funds will pay for abortions and in addition provide significant new support for pregnant women," Keehan said. "Especially now that a public health insurance option is no longer on the table, we are increasingly confident that Senator Casey's language can achieve the objective of no federal funding for abortion. We urge Congress to continue its work toward the goal of health reform that protects life at all stages while expanding coverage to the greatest possible number of people in our country."

As Politics Daily and other outlets did, the Times also contrasted that with the Dec. 18 statement from Cardinal Daniel DiNardo, archbishop of Galveston-Houston and point man for the United States Conference of Catholic Bishops (USCCB) on abortion issues.

In his statement, DiNardo welcomed Casey's "good-faith effort to improve this bill" but said it came up short in terms of barring abortion funding. "We continue to oppose and urge others to oppose the Senate bill unless and until this fundamental failure is remedied," DiNardo said, adding that the bishops considered health care reform an "urgent national priority" and that they would continue to press Congress to improve the bill.

The Times piece also quoted Colorado Rep. Diana DeGette (D-Colo.), co-chair of the Congressional Pro-Choice Caucus and leading advocate for abortion coverage, saying: "We have known for quite some time that the Catholic hospitals and also the nuns are really breaking from these hard-line bishops."

Is there in fact a schism between the major players in the Catholic health care lobby? Keehan says no way, and she is clearly miffed about the way the Times' story played up the difference.

"There is not a shred of disagreement between CHA and the bishops," Keehan told Catholic News Service on Monday. "We believe there is a great possibility and probability that in conference committee we can work toward a solution that will prevent federal funding of abortion."

"I understand that it doesn't make a good story to say (CHA and the USCCB) are working together," she added. "But it would have been an honest story."

Catholic conservatives jumped on Keehan's statements, with longtime Catholic adviser to Republicans Deal Hudson writing that Keehan was now "backtracking" after siding against the bishops and with "organizations who have repeatedly demonstrated their allegiance to the Democratic Party and the Obama White House by subordinating the non-negotiable life issues to political success."

So which is it -- division or distortion?

Perhaps a bit of both. To be fair, Sister Keehan's CHA statement came out on Dec. 17, a week before the final Senate vote on Dec. 29 and nine days before the Times story. She had not commented on the final Casey-Nelson language or the Senate bill as passed, nor did the CHA respond to the Times' request to elaborate. Also, Keehan couched her support in the Dec. 17 statement, noting that she hadn't seen the final language and was committed to working with Congress to get the bill where it needed to be.

There is also a bit of the "good cop, bad cop" routine going on as well, with the bishops tending to pursue the perfect over the good and criticizing any compromise as "deficient" and unworthy of support from Catholics. For example, a follow-up statement from the USCCB on Dec. 22 said the Senate bill has "fundamental flaws" not only in abortion funding but also on affordability for poor people and greater access for immigrants, undocumented and otherwise.

On the other hand, the CHA and the religious orders of nuns that generally operate Catholic hospitals tend to be more pragmatic, weighing particular problems with the greater good that can be achieved and focusing on the political process as a way to resolve any problems either now or through future legislation. It is a difference one often sees between pastors who often deal with people where they are and bishops who often deal in abstractions and whose priority is to defend principles from erosion. Both can be effective approaches in political negotiations.

But there is also little doubt that Keehan and the Catholic hospitals, like many Catholic activists promoting the church's social justice teachings, are far more supportive than the hierarchy of Obama's agenda and see the prospect of health care reform as representing a major, albeit imperfect, advance in the common good.

"The failure of the Catholic Health Association to follow the bishops' conference's lead in opposing the Casey compromise and the eventual Senate legislation lends plausibility to the idea of a private parting of ways on the issue," concluded an article at Catholic World News. "Reports of a public split, however, seem premature."

Such an open split also seems unlikely given the power of the bishops conference and the fact that the USCCB and the CHA want the same thing on health care reform. But as the inevitable compromises of the political process continue to bump up against the inflexibility of the bishops' position on abortion funding, some fissures are likely to emerge -- and more likely than ever to remain private.

The real question is whether such differences of opinion, even in private, will create space for Senate and House conferees to back compromise language on abortion funding -- and provide cover for enough pro-life Democrats to vote for a final bill that the bishops may not support.

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